Unobtrusive monitoring of patients with dementia in nursing

homes facilities:first results from an experimental

set-upCarlos Chiatti(1), Susanna Spinsante(2), Ennio Gambi(2),

Lorena Rossi(1), Laura Raffaeli (2)

(1) INRCA Ancona, Italy (2) Università Politecnica delle Marche, Italy

AAL Forum – 24th September 2015, Ghent (Belgium)

Monitoring people in private spaces: technological advances and societal issuesPart I - Technological advances for monitoring people

Integrated system for the comfort and safety of Alzheimer’s patients in nursing homes

• The problem:Increasing incidence of Alzheimer’s Disease (AD) patients among population, decreasing availability of resources (financial, time, operators) to assist them

• The solution:Designing effective AAL technologies to prolong AD patients independent living at home as much as possible, to relieve burden of assistance on caregivers and to improve effectiveness of care in nursing homes, while reducing costs

• The aim of the project:To evolve and update the already existing Up-Tech product designed to be used at home, to be adopted in nursing homes (RSA) as a support tool for nurses and RSA operators

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AUTOMA Srl DIIUNIVPM

UpTech_RSAKit

(RSA)(Residenza Sanitaria

Assistenziale = nursing home)

UpTechKit

(home)

Evolution of the project

"Innovation vouchers” for the WIDER* Project: purchase of consultancy and assistance services aimed at the implementation of innovation projects.[ * http://www.wider-project.eu/about.html ]

AD often affects also patients' families, who are in charge of care Family caregivers are subjected to high levels of stress Risk of developing mood disorders, depression, insomnia,

which in turn contribute to the onset of physical problems

Main objectives of the project:• Improve the quality of life of family caregivers of AD

patients• Promote the permanence at home of people affected by AD

Tools:• application of innovative methods and technologies to

improve the efficiency of the care processes

The study: • more than 400 families: a group of them (150) have

accepted to install the technological kit at home4

The UpTech Project

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The UpTech kit

• Network of wireless sensors (Sub-GHz technology)• A main control unit in charge of information processing and

alarm generation• Alarms sent to caregivers through GSM/GPRS

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The UpTech_RSA kit

• Multiuser solution, designed for nursing homes• A network of wireless sensors in every room• Alarms sent to nurses through desktop and tablet interfaces

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RequirementsOBJECTIVE: Unobtrusive monitoring

• Simple environmental sensors• Acceptance by the monitored patients• Privacy issue: anonymous data

Wireless sensors

Simple installation Battery powered: pay attention to the energy

consumption

Designed for night use

Designed according to nurses’ requests and expectations

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Network of wireless sensorsFunctionalities:

1) Door opening detection2) Window opening detection3) “French-window” opening detection

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4) Presence detection to bed

5) Presence detection in the bathroom

Network of wireless sensors

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Data processing and storageThe PC filters the information coming from the sensors:

• data related to events are saved in a local database • data referred to the operating status of the sensors are

verified in order to monitor the correct operation

Database remotely accessible

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Desktop and mobile interfaces• Desktop interface: "two parties" and “multiuser” versions

• Mobile interface for tablet and smartphone

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Field trialFirst experimental realization:

“RSA VILLA COZZA”, Macerata (Marche Region, IT)

Kit installation in 2 rooms, occupied by 2 patients affected by AD

The most important critical issue: lack of a data communication infrastructure (local network)

Solution: creation of multiple radio links (Wi-Fi, Hiperlan)

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FeedbackThe opinion of the nurses about the experimental realization at “RSA VILLA COZZA”, Macerata (Marche Region, IT)

• Overall opinion on the technological kit:

• Is the kit easy to use?

89%

11%

PositiveNegativeMedium

100%

YesNo

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Feedback

• Do you think that the patients monitored have suffered a stress?

• Do you think that the kit has been a source of stress for nurses?

• Do you think that the kit can improve the assistance provided in nursing homes?

6%

94%

YesNo

100%

YesNo

61%

39% Absolutely yesNoQuite a lot

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Feedback

• Would you recommend the use of this kit in nursing homes?

• Dangerous episodes detected by the kit: n. 2 opened windows n. 1 fall of a patient out of the room

• How to improve the UpTech_RSA kit? It is necessary to avoid false alarms Use only the “under the mattress” bed sensor Provide also an audio alarm to catch the attention of

nurses

100%

YesNo

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Data analysisData analysis over a period of 2 months, referred to one room

x = Bed sensor detection x = Bed sensor detection + detection in the bathroom within 4 min.

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Data analysis

o = Bed sensor detection + door opening detection within 4 min.

Data analysis over a period of 2 months, referred to one room

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ConclusionsChallenges: • Need to offer assistance to a growing number of patients• Need solutions both at their homes and at the nursing

homes• Specific requirements depending on the type of patients

Main advantages brought by UpTech_RSA:• Innovation• Efficient use of resources• Quality of care improvement• Support for the nurses for patients monitoring

Possible future development:• Extend the pool of monitored patients• Adapt the current solution to patients with different

pathologies

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ReferencesUpTech Project:

• http://uptech.regione.marche.it• Chiatti C, Masera F, Rimland JM, Cherubini A, Scarpino O,

Spazzafumo L and Lattanzio F. “The UP-TECH project, an intervention to support caregivers of Alzheimer's disease patients in Italy: study protocol for a randomized controlled trial”. Trials 14, 155 (2013).

UpTech_RSA Project:

• E. Gambi, S. Spinsante, L. Raffaeli and G. Giorgetti. “Risultati di una collaborazione pubblico-privato. L’esperienza degli Innovation Voucher del progetto europeo WIDER”. XXVI ALASS Congress, 3-5 September 2015, Ancona (IT).

Thank you!

Laura RaffaeliDipartimento di Ingegneria dell’InformazioneUniversità Politecnica delle Marche – Ancona, Italyl.raffaeli@univpm.it